Jacobs Journal of Emergency Medicine

Adolescent Presentations to Adult Hospital Emergency Departments: Systematic Review

Published on: 2018-06-04

Abstract

Background: Adolescents access either paediatric or adult emergency departments (EDs) for acute care and other health needs. Anecdotally adolescent management is perceived as burdensome in adult EDs, with complex chronic illness cited as a specific issue. This systematic review aimed to describe what is known of adolescent presentations made to adult hospital EDs.

Methods: The systematic review was conducted according to PRISMA Guidelines. OVID-MEDLINE, EMBASE, WEB OF SCIENCE and CINAHL was searched from the beginning of the databases up to January 2016 for peer-reviewed journal articles reporting on 10-19 year-old presentations made to adult hospital EDs. It was not always possible within a dataset to isolate the 10-19 year-old data. Endpoints pertaining to demographic, diagnostic and other characteristics were examined.

Results: Four manuscripts of single and multi-site studies were included, all of North-American origin with a total participant sample of 8,415,366 adolescents. Physical injury was the most common cause of presentation, accounting for nearly 50% of presentations. The prevalence of chronic illness represented 35.2% of the sample in one study. Another study reported 22% of their sample was triaged as non-urgent and 52.2% of all visits occurred at night.

Conclusion: The limited findings are consistent with global adolescent morbidity data. Characterisation of adolescent-specific presentations to adult-specific emergency care settings is limited by inability to separate datasets into the specific age group. We were not able to confirm on data available that acute presentations on the background of chronic illness made up a significant management load.

Keywords

Adolescent, Emergency Department, Adult Hospital, General Hospital